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Alternative humeral tubercle fixation in shoulder hemiarthroplasty for fractures of the proximal humerus.

Abstract：

HYPOTHESIS:We hypothesize that the sling technique provides better long term tuberosity fixation in hemiarthroplasty for severe fractures of the proximal humerus. BACKGROUND:After hemiarthroplasty for proximal humeral fractures, problems exist with deterioration of shoulder function by secondary displacement of the initially fixated humeral tuberosities. This study evaluated a new technique for fixation of the greater and lesser tuberosities in uncemented hemiarthroplasties in severely displaced 3- or 4-part proximal humeral fractures. MATERIALS AND METHODS:A consecutive series of 31 uncemented hemiarthroplasties using the new sling technique to repair the tuberosities was evaluated clinically and radiographically with special emphasis on the head-to-tuberosity distance (HTD). A historical cohort of 10 similar uncemented hemiarthroplasties was the control group in which the drill-hole technique was used for fixation of the humeral tuberosities. RESULTS:The sling technique had an overall better tuberosity positioning in terms of HTD compared with the drill-hole technique (8 vs 1 mm; P = .025, U test). There were significantly more normal HTD values in the sling-technique group (81% vs 44%; P = .032, chi(2) test). In the anatomic HTD group, the Constant score (70 vs 52; P = .009), patient satisfaction (7.1 vs 5.7; P = .038), and visual analog scale score (3.2 vs 5.2; P = .025) were statistically significantly superior compared with the nonanatomic HTD group. CONCLUSION AND DISCUSSION:The sling technique for tuberosity fixation seems to provide solid fixation. In this study, anatomic HTD fixation was associated with significantly better functional outcome, patient satisfaction, and pain scores.

journal_name

J Shoulder Elbow Surg

journal_title

Journal of shoulder and elbow surgery

authors

Pijls BG,Werner PH,Eggen PJ

doi

10.1016/j.jse.2009.05.018

subject

Has Abstract

pub_date

2010-03-01 00:00:00

pages

282-9

issue

2

eissn

1058-2746

issn

1532-6500

pii

S1058-2746(09)00285-7

journal_volume

19

pub_type

杂志文章

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